CLASS Act: Health care reform and long-term care

Mitsu Yasukawa/ The Star-Ledger If the CLASS Act stays in the current health reform plan, taxpayers may be paying for long-term care insurance. By Ethan Ellis/ NJ Voices Guest Blogger

The Community Living Assistance Services and Supports Act, known for obvious reasons of brevity and convenience as the CLASS Act, is all that is left of the organized disability community’s once ambitious agenda for health care reform.

It alone survives in both the Senate and House bills that will go to the Conference Committee early in the New Year. That means that it is likely to be in the final bill that goes to the White House for Obama’s signature sometime in 2010.

Briefly, the CLASS Act would mandate payroll deductions for long-term care insurance. Specifically, it would provide $50 or $100 a day for in-home supports for any covered worker who acquires a disability.

How much would be determined by the nature and severity of the disability. The employee would have to pay into the system for five years before coverage begins and enrollment would be automatic. Any employee not wishing to be covered would have to opt out.

Until recently the CLASS Act hasn’t attracted much attention outside the disability community where it originated. Larger, sexier issues, backed by more money and muscle, have shouldered it aside.

The other day, however, a lengthy Associated Press article about it appeared in our local press. It was somewhat critical of the bill and some of my more radical friends encouraged me to blog about it.

Now there’s no doubt that long-term care is ruinously expensive and can wipe out a family’s savings in the blink of an eye. It is usually provided in nursing homes at $40,000 or $50,000 a year and most often paid for by Medicaid, but only after a family’s assets have dwindled to $2,000.

You can buy insurance for it on the private market for several thousand bucks a year but few Americans can afford to pay that on top of their constantly rising regular medical insurance.

As the 76 year-old father of a 4 year-old, I started buying it when he was born but few families have that kind of reason for making such an expensive investment.

On the other hand, payments under the CLASS Act wouldn’t be cheap either. According to the AP story, they would range from $100 to $240 a month, with poor folks and students paying only $5 a month. Since the program must be self-supporting, without cost to the taxpayers, these rates might rise and there’s no provision that the benefit would rise with them, even if the costs of supports do.

The main criticism leveled at the CLASS Act is that people would be tricked into enrolling because they would have act affirmatively to opt out of the program, “tricked into doing what is good for them,” as the article quoted an opponent as saying. Given how much trickery health insurance companies employ to make us do what is bad for ourselves, I found that argument underwhelming.

As someone who believes that health care is a right that should be free to all and paid for out of general tax revenues, I have a greater concern. The more programs we create to make people pay for a particular health care service, the harder it will be to unravel the current system and reach the holy grail of a single-payer plan, the system that makes health care a right in every other advanced nation but ours.

Ethan Ellis is president of Next Step: People with Disabilities for Social and Economic Justice in Edison.